title: Canada Acute Coronary Syndrome Risk Score: a new risk score for early prognostication in acute coronary syndromes.
abstract: BACKGROUND
  Despite the availability of several acute coronary syndrome (ACS) prognostic risk scores, there is no appropriate score for early-risk stratification at the time of the first medical contact with patients with ACS. The primary objective of this study is to develop a simple risk score that can be used for early-risk stratification of patients with ACS.
  
  
  METHODS
  We derived the risk score from the Acute Myocardial Infarction in Quebec and Canada ACS-1 registries and validated the risk score in 4 other large data sets of patients with ACS (Canada ACS-2 registry, Canada-GRACE, EFFECT-1, and the FAST-MI registries). The final risk score is named the Canada Acute Coronary Syndrome Risk Score (C-ACS) and ranged from 0 to 4, with 1 point assigned for the presence of each of these variables: age ≥75 years, Killip >1, systolic blood pressure <100 mm Hg, and heart rate >100 beats/min. The primary end points were short-term (inhospital or 30-day) and long-term (1- or 5-year) all-cause mortality.
  
  
  RESULTS
  The C-ACS has good predictive values for short- and long-term mortality of patients with ST-segment elevation myocardial infarction and non-ST-segment elevation ACS. The negative predictive value of a C-ACS score ≥1 is excellent at ≥98% (95% CI 0.97-0.99) for short-term mortality and ≥93% (95% CI 0.91-0.96) for long-term mortality. In other words, a C-ACS score of 0 can potentially identify correctly ≥97% short-term survivors and ≥91% long-term survivors.
  
  
  CONCLUSIONS
  The C-ACS risk score permits rapid stratification of patients with ACS. Because this risk score is simple and easy to memorize and calculate, it can be rapidly applied by health care professionals without advanced medical training.
authors.affiliation: Division of Cardiology, McGill Health University Center, Quebec, Canada. thao.huynhthanh@mail.mcgill.ca
authors.forename: Thao
authors.initials: T
authors.lastname: Huynh
authors.forename: Simon
authors.initials: S
authors.lastname: Kouz
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Yan
authors.forename: Andrew
authors.initials: A
authors.lastname: Yan
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Loughlin
authors.forename: Jennifer O
authors.initials: JO
authors.lastname: Loughlin
authors.forename: Erick
authors.initials: E
authors.lastname: Schampaert
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Yan
authors.forename: Raymond
authors.initials: R
authors.lastname: Yan
authors.forename: Stephane
authors.initials: S
authors.lastname: Rinfret
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Eisenberg
authors.forename: Marc
authors.initials: M
authors.lastname: Afilalo
authors.forename: Alice
authors.initials: A
authors.lastname: Chong
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Dery
authors.forename: Michel
authors.initials: M
authors.lastname: Nguyen
authors.forename: Claude
authors.initials: C
authors.lastname: Lauzon
authors.forename: Samer
authors.initials: S
authors.lastname: Mansour
authors.forename: Dennis T
authors.initials: DT
authors.lastname: Ko
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
authors.forename: Shaun
authors.initials: S
authors.lastname: Goodman
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D002170:Canada / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends